Protein C is a vitamin K-dependent glycoprotein produced in the liver and circulated in blood as an inactive enzyme precursor. In order to get itself activated, protein C binds to endothelial proteoglycan thrombomodulin, generally catalyzed by thrombin. The anticoagulant activity by activated protein C is exerted primarily through inactivation of coagulation factors viz. VIIIa and Va, which are required for activation of factor X and production of thrombin. The catalytic activity of the activated protein C requires assistance of protein S, a vitamin K-dependent co-factor. Protein S assists protein C in the inactivation of coagulation factors viz. Va and VIIIa. The half-life of protein C is eight hours and that of protein S is 30 hours.
Lack of activated protein C interrupts and disturbs the equilibrium between procoagulant and anticoagulant proteins and stimulates a prothrombotic environment. Apart from maintaining balance or equilibrium, activated protein C helps in maintaining an appropriate flow of the venous circulation with prolonged exposure of platelet phospholipids and procoagulant proteins. Statistically, the protein C deficiency occurs in approximately one in every 200–500 individuals, whereas the protein S deficiency is found in approximately one in every 20,000 individuals. The disease caused by the absence of any of the natural anticoagulants leads to thrombophilia. The absence or low level of natural anticoagulants is either due to hereditary defects; or acquired out of circumstances such as surgery, cancer; or due to certain contraceptives and menopausal hormone replacement products.
Diagnosis of the deficiency of proteins C and S is generally carried out with the help of blood tests conducted to measure the level and activity of natural anticoagulants. The blood test is recommended to be conducted at least 3–4 weeks after discontinuation of medicines such as heparin or warfarin. Several physicians and health care experts suggest repeat test, as abnormal or false results are very common in case of this test. This may be because of pregnancy or presence of birth control pills demonstrating a reduced level of protein C or S. Recent studies have shown that proteins C and S may induce chances of acquiring arterial blood clots in people aged 55 years or below. Major drivers for the market include growing awareness among people with respect to genetic defects and increasing trend of regular health checkups in developed countries. Major restraints for the proteins C & S market include possible anxiety regarding the diagnosis that never shows symptoms and lack of insurance coverage.
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Geographically, the global proteins C & S market has been segmented into North America, Europe, Asia Pacific, Latin America, and Middle East & Africa. The market in North America is expected to expand during the forecast period, followed by Europe. Growth of the market in North America is attributable to increase in demand for advanced treatments, rise in health care expenditure, and high diagnosis rate.
Asia Pacific is an emerging market due to developing health care infrastructure, increasing government expenditure, growing patient awareness, and rising number of patients suffering from deficiency of proteins C and S. However, lack of insurance coverage, limited access to health care facilities, and lack of patient education are restraining the proteins C & S market in regions such as Middle East & Africa and Latin America.
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Some of the major companies operating in the proteins C & S market are Baxter International Inc., Abbott Laboratories, Trinity Biotech, Siemens AG, Zycare, Inc. Becton, Dickinson and Company, and Sienco Co., Ltd.